Journal of evaluation in clinical practice最新文献

{"title":"Prevalence of Adverse Events in Mexico Using the Institute for Healthcare Improvement—Global Trigger Tool Method: A Retrospective Study","authors":"Luis Meave Gutierrez-Mendoza,&nbsp;Elizabeth Manias,&nbsp;Patricia Nicholson","doi":"10.1111/jep.70405","DOIUrl":"10.1111/jep.70405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Globally, adverse events (AEs) are a major contributor to mortality, often arising from healthcare management rather than patients' underlying conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to estimate the prevalence of AEs in three different hospitals in central-north Mexico using the Institute for Healthcare Improvement Global Trigger Tool (IHI-GTT) method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective review of hospital discharges (July 2022 to June 2023) was conducted in three hospitals using the IHI-GTT method. Records of patients aged ≥ 18 years with hospital stays longer than 24 h were reviewed, with obstetric and paediatrics cases excluded. One experienced physician performed the two-stages review process, with inter-rater reliability assessed on 1% of records. Logistic regression analysis was used to identify factors associated with AEs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3354 discharges, 36.6% (<i>n</i> = 1227) experienced at least one adverse event (AE), corresponding to 72.79 AEs per 1000 patient-days or 53.04 AEs per 100 admissions. Of these, 72.8% (<i>n</i> = 893) were preventable. The most frequent AEs were medication errors (23.6%), intravenous line errors (23.5%), hospital acquired infections (16.4%), and surgical (9.9%). The AEs contributed to the death of the patient in 14.6% (<i>n</i> = 179) of cases. Risk factors for AEs included hospital transfers (OR: 1.53; 95% CI: 1.25–1.87, <i>p</i> &lt; 0.001), age ≥ 60 years (OR: 1.49; 95% CI: 1.22–1.83, <i>p</i> &lt; 0.001), comorbidities (OR: 1.15; 95% CI: 1.08–1.23, <i>p</i> &lt; 0.001), and longer hospital stay (OR: 1.13; 95% CI: 1.11–1.14, <i>p</i> &lt; 0.001). Elective admissions showed a protective effect (OR: 0.77; 95% CI: 0.62–0.97, <i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of AEs in Mexico, a middle-income country, is higher than previously reported. These finding underscore a pressing public health challenge requiring targeted interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming Big Data Interoperability Challenges Generated by Ubiquitous Devices Outside Traditional Health Systems: A Systematic Review Protocol","authors":"Keaton Banik,&nbsp;Jamin Patel,&nbsp;Sheriff Tolulope Ibrahim,&nbsp;Tarun Katapally","doi":"10.1111/jep.70410","DOIUrl":"10.1111/jep.70410","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Rationale&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ubiquitous devices such as smartphones, wearables, and personal gadgets generate large volumes of personalized health data outside of traditional health systems. Despite its abundance, differences in data formats and semantics across hardware, platforms and sectors keep information siloed. As a result, valuable precision health and social insights are lost when training or validating predictive health models. Interoperable data pipelines that operate across non-clinical settings are needed so this data can be responsibly translated into actionable information for personal and public health.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims and Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review protocol aims to evaluate existing methodologies that address the interoperability challenges when integrating multimodal health data from ubiquitous devices into non-clinical health infrastructures. The systematic review seeks to identify primary barriers (technical, semantic, organizational, and regulatory), describe current solutions, and pinpoint gaps that hinder seamless exchange and use of such data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A comprehensive literature search will be conducted across multiple databases (PubMed, IEEE Xplore, ACM Digital Library, and Web of Science) for peer-reviewed primary studies from 2014 to 2024. Gray literature and conference proceedings are excluded. Eligible studies empirically evaluate a framework, architecture or tool that enables technical, semantic, organizational, and regulatory interoperability for person-generated health data outside clinical settings. Two reviewers will conduct title and abstract screening and full-text screening in Covidence using predefined criteria, with blinding of authors, journal, and year. Disagreements will be resolved by consensus or a third reviewer. Data will be extracted in Microsoft Excel, and methodological quality will be assessed with the Mixed Methods Appraisal Tool (2018). Interoperability methodology synthesis will be primarily narrative with evidence tables. Where comparable quantitative outcomes exist, we will compute effect sizes and consider robust statistically significant findings (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Anticipated Implications&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review protocol will sufficiently assemble a comprehensive and reproducible evidence base to conduct the review. The completed review will synthesize and critically appraise peer-reviewed approaches to interoperability for ubiquitous device-generated personal health data ","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Service Evaluation of the Appropriateness of Nil by Mouth Decisions in an Acute Hospital Trust","authors":"Camilla Dawson,&nbsp;Kaveh Manavi,&nbsp;James Hodson","doi":"10.1111/jep.70406","DOIUrl":"10.1111/jep.70406","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Use of a ‘nil by mouth’ (NBM) recommendation is common for patients undergoing general anaesthesia, or where there are concerns around the risk of aspiration or patency of the digestive tract. However, inappropriate use of a NBM recommendation can increase the risk of malnutrition and dehydration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To explore how, why and when NBM decisions are made, and to identify factors associated with the appropriateness of these decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective service evaluation was performed in a large acute hospital trust in the UK.</p>\u0000 \u0000 <p>All periods of NBM in adult inpatients that commenced in January and February 2022 were identified and reviewed to classify the appropriateness of the clinical decision to commence NBM, and of the duration of NBM. Results were disseminated to clinicians to identify potential explanations for the findings and to surface potential solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of <i>N</i> = 1273 periods of NBM, the majority were due to pre-operative (46.5%) or pre-procedural (32.4%) fasting; most commenced in the early morning (53.9% between 0:00–7:59). The decision to commence NBM was deemed clinically inappropriate in 2.8% of cases, with this being significantly more likely where NBM commenced during the weekend (5.6% vs. 1.8%, <i>p</i> = 0.003) or in the evening (6.3% vs. 1.1% for 17:00–23:59 vs. 0:00–7:59, <i>p</i> = 0.001), in comparison to core weekday working hours. The median duration of NBM was 12.9 h (interquartile range: 7.5–20.3), with this duration being inappropriate in 21.4% of cases. On presenting these findings, clinicians identified unclear communication and documentation of NBM requirements to be major contributors to the inappropriate use of NBM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Inappropriate use of NBM is uncommon at our institution but is more likely where this is commenced in evenings or weekends. The cessation of NBM was inappropriately delayed in over a fifth of cases, with poor communication and documentation likely to be a major contributor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes of Nurses and Nursing Students Towards Each Other During Clinical Practice: A Comparative Study","authors":"Gül Güneş Aktan,&nbsp;Gamze Göke Arslan","doi":"10.1111/jep.70407","DOIUrl":"10.1111/jep.70407","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the clinical practice process, students learn to apply theoretical knowledge in practice, develop competence in practical skills, and organize nursing care activities. In this process, nurses' professional, pedagogical, and communication skills, along with their clinical experience, play a crucial role in guiding and evaluating students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study is to determine the attitudes of nurses toward nursing students and of students toward nurses in clinical practice, as well as the factors influencing these attitudes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive design was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The population consisted of nursing students and nurses across the country. A total of 651 participants were included in the study, comprising 341 students and 310 nurses. Data were collected using the “Individual Assessment Form for Nurses”, “Individual Assessment Form for Nursing Students”, “Attitude Scale of Nurses Towards Nursing Students”, and ‘Attitude Scale of Nursing Students Towards Nursing’. The online survey was created by researchers using Google Forms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to the findings, students' attitudes toward nurses were moderate, whereas nurses' attitudes toward students were more positive. Nurses' attitudes were influenced by their years of professional experience, while students' attitudes were affected by age, gender, academic year, experience of anxiety in the clinical setting, and the adequacy of nurse mentorship (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings show that nurses and students do not have similar attitudes toward each other on the same topics and situations. It is emphasized that educational programs, institutional support, and nurses' motivation for mentoring should be increased to strengthen mutual understanding and cooperation in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Students' Experiences With Artificial Intelligence: A Qualitative Study on Education, Clinical Practice, and Future Expectations","authors":"Necibe Dagcan Sahin,&nbsp;Mehmet Yildirim","doi":"10.1111/jep.70413","DOIUrl":"10.1111/jep.70413","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the rapid advancement of technology in healthcare, artificial intelligence (AI) has become an important tool in nursing education and clinical practice. However, there is limited knowledge regarding nursing students' experiences with AI, its areas of use, and their expectations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to explore nursing students' experiences with AI and to reveal its role in nursing education, clinical practice, and future expectations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative phenomenological design was used. Face-to-face interviews were conducted with 14 nursing students from a state university who had been using AI between June and August 2025. Data were collected using a Demographic Information Form and a Semi-Structured Interview Form. The interviews were recorded, transcribed verbatim, and analyzed using Braun and Clarke's thematic analysis method with the support of MAXQDA software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six main themes and fourteen subthemes emerged: (1) First encounters with AI and sources of information, (2) AI in nursing education, (3) AI in clinical practice, (4) Benefits of AI, (5) Limitations and concerns regarding AI, and (6) Future expectations and recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nursing students perceived AI as a supportive tool but emphasized that it cannot replace human-centered care, empathy, or therapeutic communication. The findings highlight the need to integrate AI into nursing education and clinical practice within an ethical and pedagogical framework.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Psychometric Testing of the Breastfeeding Knowledge Scale (BKS) in Brazilian Healthcare Students","authors":"Patrícia Lima Pereira Peres,&nbsp;Rachele Simeon,&nbsp;Maria Helena do Nascimento Souza,&nbsp;Giovanni Galeoto,&nbsp;Thaís Emanuele da Conceição,&nbsp;Anna Berardi,&nbsp;Donatella Valente,&nbsp;Rosane Harter Griep","doi":"10.1111/jep.70409","DOIUrl":"10.1111/jep.70409","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Breastfeeding is recognized as a cornerstone of maternal and child health, yet health professionals frequently report insufficient knowledge to provide effective support. Strengthening the evaluation of educational outcomes in health professions training is therefore essential to improve clinical practice and patient care. This study aimed to develop and validate the Breastfeeding Knowledge Scale (BKS), a tool to assess breastfeeding-related knowledge among health professions students in Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study followed COSMIN guidelines. Concept elicitation was conducted through workshops with experts and students to identify relevant domains of breastfeeding knowledge. A pilot study, including cognitive interviews with students, evaluated the comprehensibility and comprehensiveness of items. Content validity was assessed with both students and a multidisciplinary panel of professionals using the content validity index (CVI) and content validity coefficient (CVC), complemented by qualitative feedback. Psychometric testing included exploratory factor analysis (EFA) to evaluate structural validity and guide item reduction, followed by assessment of internal consistency with Cronbach's <i>⍺</i>, calculated only after confirming the unidimensionality of each subscale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The concept elicitation process yielded five thematic clusters that were reorganized into three broader domains: Biological aspects of lactation, Policy and Sociocultural Context and Clinical Management (including complementary feeding). After iterative refinement and EFA, the instrument was reduced to 40 items. The final version was administered to 143 students. Internal consistency was excellent for the overall scale (Cronbach's <i>⍺</i> = 0.910) and strong for each domain (biological = 0.810; policy and sociocultural context = 0.790; clinical management = 0.796). These results supported both structural validity and reliability of the BKS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BKS is a valid and reliable instrument for evaluating breastfeeding-related competencies in health professions students. By providing a comprehensive and psychometrically sound measure, it enables rigorous evaluation of training adequacy, supports curriculum improvement and ultimately contributes to strengthening clinical practice and breastfeeding outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Implementation of Shared Decision-Making in Primary Care: A Study With Unannounced Standardized Patients","authors":"Mahima Khan,&nbsp;Shelley Yu,&nbsp;Abigail Henderson,&nbsp;David Garcia,&nbsp;Matthew Kijowski,&nbsp;Kathleen Hanley,&nbsp;Lisa Altshuler","doi":"10.1111/jep.70404","DOIUrl":"10.1111/jep.70404","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale, Aims, and Objectives</h3>\u0000 \u0000 <p>Shared decision making (SDM) is widely endorsed in clinical guidelines, yet clinicians may not use it consistently across different clinical problems. This study explores how SDM is influenced by the clinical topic under discussion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using unannounced standardized patients (USPs), we observed how resident physicians engaged in SDM during new patient visits involving both gastroesophageal reflux disease (GERD) and smoking cessation. Audio recordings were evaluated using the validated Observer OPTION-5 tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SDM scores were significantly higher in smoking cessation discussions than in GERD management. Residents more frequently integrated patient preferences when discussing smoking but gave more information when managing GERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Residents appeared to adjust their SDM behaviors based on topic, suggesting context-dependent application. Educational interventions should address this variability and promote balanced use of SDM across routine and behaviorally complex decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing System Empathy Within a UK Emergency Department: A Feasibility Interprofessional Priority Setting Exercise","authors":"Jeremy Howick,&nbsp;Andy Ward,&nbsp;Charlotte Grantham,&nbsp;Amber Bennett-Weston","doi":"10.1111/jep.70394","DOIUrl":"10.1111/jep.70394","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Empathy in healthcare benefits patients and practitioners, yet system-level barriers inhibit empathy. The barriers include burnout-inducing administrative workloads, burdensome protocols, lack of wellbeing spaces, un-empathic leadership, and not emphasising empathy as an institutional value. A workshop aimed at enhancing empathic systems was successfully delivered in Canada but has not been tested in the UK National Health Service (NHS) setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to test the feasibility of an empathic systems workshop within the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted an interprofessional workshop with stakeholders from an emergency department (ED). We used a modified nominal group technique to prioritise actions that enhance empathy in the ED. Satisfaction with the workshop and confidence that the workshop would lead to positive change were measured on a 10-point Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight participants representing the following stakeholder groups attended the workshop: medical consultants, nurses, and porters. The group agreed to generate an improved wellbeing plan and to implement an effective secondary triage system. Seventy-three percent (73%) rated their satisfaction with the workshop as eight or higher out of ten, and 63% reported being confident that the workshop would lead to improvements in system empathy. A doctor strike limited the range of stakeholders who were able to attend, and long-term follow up was not conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participants in a UK setting were satisfied with a previously developed system empathy workshop, were able to prioritise changes that would improve system empathy, and were confident that the changes would be effective.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Profit and Patient-Centredness: Nurses' Perspectives on Artificial Intelligence Adoption in Healthcare Businesses","authors":"Mst Masuma Akter Semi,&nbsp;Arif Hosen,&nbsp;Moustaq Karim Khan Rony,&nbsp;Srabani Das,&nbsp;Md Bayzid Kamal,&nbsp;Sumaiya Yeasmin,&nbsp;Mashuk Rahman Utsho,&nbsp;Jakir Hossain Ridoy","doi":"10.1111/jep.70408","DOIUrl":"10.1111/jep.70408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence (AI) is increasingly embedded in healthcare businesses, promoted for its ability to enhance efficiency, reduce costs and optimize workflows. However, the intersection of profit-driven priorities with patient-centred values presents significant ethical and professional challenges for nurses, who serve as the frontline mediators between technology and patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to explore nurses lived experiences of AI integration in healthcare businesses, focusing on how they navigate tensions between institutional efficiency and their professional commitment to patient-centred care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An interpretive phenomenological design was employed to capture the depth of nurses' perspectives. Data were collected between May and June 2025 through 26 semi-structured interviews and 1 focus group with 7 nurses, yielding a total of 33 participants from AI-integrated private hospitals. Transcripts were analyzed thematically, with trustworthiness ensured through member validation, audit trails and reflexive journaling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four overarching themes emerged. Nurses reported emotional and ethical conflicts when AI recommendations contradicted clinical judgement, often leading to moral distress. Business imperatives were perceived to prioritize efficiency over individualized care, with nurses excluded from decision-making about AI adoption. Many participants expressed anxiety over role displacement and a diminishing sense of autonomy, although some redefined their professional identity as technology navigators. Inadequate training and lack of institutional support further amplified challenges, leaving nurses underprepared to manage AI tools effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While AI offers organizational advantages, its integration without inclusive planning and adequate training risks undermining holistic nursing practice. Strengthening institutional support, valuing nurses' input and balancing efficiency with empathy are essential to align technological innovation with compassionate, patient-centred care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Assessment of Cancer Patient Performance Status Documentation in a Large, Multicentre Hospital System","authors":"Guillaume Lamé,&nbsp;Mohamed El Mejdani,&nbsp;Ariel Cohen,&nbsp;Sonia Priou,&nbsp;Rémi Flicoteaux,&nbsp;Matthew Barclay,&nbsp;Christophe Tournigand,&nbsp;Marie Verdoux,&nbsp;Emmanuelle Kempf","doi":"10.1111/jep.70411","DOIUrl":"10.1111/jep.70411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The performance status (PS) is an indicator of a cancer patient's ability to perform everyday activities and plays a key role in oncology. Research suggests that the documentation of PS scores in electronic health records (EHR) is deficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed PS score documentation (Karnofsky or ECOG/Zubrod/WHO) in the hospital, consultation, and multidisciplinary team meeting (MDT) records of patients newly referred for a cancer at a large, public, multisite hospital system, between 1 January 2019 and 1 June 2021. We developed a regular expression (RegEx) to automatically identify PS in documents and assessed what patient and hospital characteristics were associated with PS documentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our RegEx achieved accuracy, and weighted- and macro-average F1 score, &gt; 0.95 for all document types. We included 68,479 patients. 35% had a documented PS between −90 and +365 days of their first ICD-10 cancer code. 18% of MDT reports contained a PS score.</p>\u0000 \u0000 <p>In multivariate analysis, without accounting for metastatic status at diagnosis, odds ratios (ORs) for PS documentation in patient files varied by cancer type, from 0.47 (95% confidence interval: [0.42; 0.52]) for genitourinary to 3.30 [3.00; 3.61] for lung cancer, and hospital, from 0.27 [0.23; 0.33] to 3.38 [3.14; 3.63]. Male patients were more likely to have a documented PS (OR = 1.08 [1.04; 1.13]), as well as older patients. The number of each type of document was positively correlated with the presence of a score. When adding metastatic status at diagnosis, the OR for metastatic status was large (3.29 [3.13; 3.46]), but associations with other covariates were not noticeably affected. Documented PS close to diagnosis was associated with poorer 1-year survival (25% of patients with PS died within 1 year, vs 12% without PS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PS score documentation was variable and generally low. Improved documentation is required if EHRs are to be used as a source of real-world data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}